Synopsis

• 3M Health Information Systems is part of 3M Health Care, one of 3M's six major business segments
• 3M Health Information Systems has been providing healthcare solutions for 25 years!
• elligence integrates 3M’s industry-leading coding compliance edits and industry-leading medical necessity compliance data
• 3M Edits help ensure compliance at every phase of the revenue cycle
• The core components of the 3M Edit Engine are the Data Sets and the Code Viewer

Validating the necessity of medical procedures helps:

• Healthcare organizations stay compliant with stringent requirements, while upholding patient safety.
• Facilities reduce denials and achieve appropriate reimbursement for services rendered.

How it works…

• Charges are saved into a batch or received by elligence from an EMR or electronic superbills
• Click Medical Necessity & Compliance
• Information for all charges is sent via a secure internet connection to be analyzed by the 3M Edit Engine
• Results are then displayed – click on any item to immediately correct any errors – PRIOR to billing!

The Data Sets

3M’s team of healthcare policy specialists—certified coders, nurses, billing experts, and health informatics professionals—create and maintain both current and historic coding and compliance data sets, including:

• CPT®/HCPCS procedure codes (including E/M)
• ICD-9 diagnostic codes
• Local Coverage Determinations (LCDs)
• National Coverage Determinations (NCDs)
• CCI (Correct Coding Initiative) Edits
• OCE (Outpatient Code Editor) type edits (including age, gender, frequency, etc.)
• State Medicaid rules
• Private payer rules
• Modifiers and additional proprietary rules
• Global surgical periods

The Code Viewer

The Code Viewer provides:

• Access to policies, diagnoses, modifiers, and CCI rules associated with each procedure for your carrier
• Direct links to LCDs
• Access to procedure and diagnosis code changes for specific time periods
• Highlights of recent policy updates
• Search-and-browse capabilities for diagnosis and procedure codes
• Means to determine correct coding initiative rules appropriate to each CPT® code
• Online review of Relative Value Units (RVUs) for each CPT® code
• Online review of the Medicare Fee Schedule calculator based on the Resource Based Relative Value Scale (RBRVS)